Do DTP and Tetanus Vaccinations Cause Asthma?

A new study in the Journal of Manipulative and Physiological Therapeutics¹ supports the findings of three previous studies that children who receive diphteria-tetanus-pertussis (DTP) or tetanus vaccines are more likely to have a "history of asthma" or other "allergy-related respiratory symptoms." The study reviewed data from the Third National Health and Nutrition Examination Survey, which was conducted by the National Center for Health Statistics from 1988 to 1994. The survey data included interviews (by proxy with parents) of 13,944 infants, children and adolescents (2 months through 16 years old).

The JMPT study addresses an issue that has much supporting evidence:

• The prevalence of allergic disorders has doubled over the last 20 years.^2-5

• In the U.S., there are currently 30-50 million asthma and allergy sufferers,^6,7 with an estimated cost of $6.21 billion in 1990.⁸

• The Institute of Medicine, which convened two committees (the Committee to Review the Adverse Consequences of Pertussis and Rubella Vaccines and the Vaccine Safety Committee) concluded that there is a causal relation between the DTP vaccine and anaphylaxis,⁹ and tetanus toxoid and anaphylaxis.¹⁰

The results of the JMPT study demonstrated that those children who had been given DTP and tetanus vaccination had significantly greater odds of asthma and allergy-related symptoms than those who had remained unvaccinated. The specific odds ratios (for vaccinated children vs. unvaccinated) are as follows:

According to these odds ratios, a child who had the DTP and tetanus vaccination is 50% more likely to experience severe allergic reactions, over 80% more likely to experience sinusitis, and twice as likely (100% more likely) to experience asthma.

In addition to these findings, the authors commented:

"Evidence was also presented showing that vaccination may be associated with different types of allergies at different ages. The vaccination may be associated with severe allergic reactions and sinusitis or sinus problems among younger children, and with asthma, wheezing and whistling, and nose and eye symptoms among adolescents.

"Six studies have recently addressed the association between pertussis or DTP immunizations and allergy-related disease. Our results are similar to findings reported from three retrospective cohort studies.

"Asthma and other allergic hypersensitivity reactions and related symptoms may be caused, in part, by the delayed effects of DTP or tetanus vaccination. One or more vaccine components may be responsible for a portion of the increased prevalence of asthma and allergies in U.S. children.

"Because the proportion of U.S. children who have received at least 1 dose of DTP vaccine approaches 100%, the number of allergies and allergy-related conditions attributable to DTP or tetanus vaccination in the United States may be very high. For example, assuming that the estimated vaccination effect is unbiased, 50% of diagnosed asthma cases (2.93 million) in U.S. children and adolescents would be prevented if the DTP or tetanus vaccination was not administered. Similarly, 45% of sinusitis cases (4.94 million) and 54% of allergy-related episodes of nose and eye symptoms (10.54 million) in a 12-month period would be prevented after discontinuation of the vaccine. The well-documented public health benefits of the DTP and tetanus vaccines must be considered in light of these potential long-term risks, which should be addressed in future studies."

1. Hurwitz EL, Morgenstern H. Effects of diphteria-tetanus-pertussis or tetanus vaccination on allergies and allergy-related respiratory symptoms among children and adolescents in the United States. J Manipulative Physiol Ther 2000;23: 1-10.

    

2. Weiss KB, Gergen PJ, Wagener DK. Breathing better or wheezing worse? The changing epidemiology of asthma morbidity and mortality. Annu Rev Publ Health 1993;14:491-513.

    

3. Seaton A, Godden DJ, Brown K. Increase in asthma; a more toxic environment or a more susceptible population? Thorax 1994;49:171-4.

    

4. Jarvis D, Burney P. ABC of allergies: the epidemiology of allergic disease. BMJ 1998;316:607-10.

    

5. Peat JK, Li J. Reversing the trend: reducing the prevalence of asthma. J Allergy Clin Immunol 1999;103:1-10.

    

6. Weiss KB, Gergen PJ, Hodgson TA. An economic evaluation of asthma in the United States. N Engl J Med 1992;326:862-2.

    

7. Naclerio R, Solomon W. Rhinitis and inhalant allergens. JAMA 1997;278:1842-8

    

8. Blaiss MS. Outcomes analysis in asthma. JAMA 1997;1874-80.

    

9. Weiss KB, Gergen PJ, Hodgson TA. An economic evaluation of asthma in the United States. N Engl J Med 1992;326:862-6.

    

10. Howson CP, Howe CJ, Fineberg HV. Adverse Effects of Pertussis and Rubella Vaccines: A report of the Committee to Review the Adverse Consequences of Pertussis and Rubella Vaccines. Washington DC: National Academy Press; 1991.

     

11. Stratton KR, Howe CJ, Johnston RB. Adverse Events Associated with Childhood Vaccines: Evidence Bearing on Causality. Washington DC: National Academy Press; 1994.